Faced with reprimand by the College, lawyers advise doctors to bow their heads and accept punishment.
If docs refuse, a mark will be put in their file. Things will go worse next time.
The College of Physicians and Surgeons of Ontario (CPSO) reports that several thousand doctors help out doing peer reviews of other doctors. This implies, as the College presents it, that many docs must love the College.
But maybe docs help out because they want peer review to be educational, not punitive? Maybe it has nothing to do with loving the College?
The CPSO also notes that most complaints are not serious. Despite the ulcers and lost sleep caused by a complaint, the majority resolve without event.
Furthermore, the CPSO says it is bound by draconian legislation and driven by activist media outlets. It’s not their fault.
Even so, most doctors cower in fear of the CPSO. Six doctors commit suicide each year in Canada while under investigation by their regulator, with no prior history of mental illness.
In my last blog, Is Self-Regulation Dead?, some readers asked for more about the concentration of power.
If there is no “self” in self-regulation, then all that’s left is an autocratic body with power to create laws, enforce laws and punish lawbreakers.
Concentration of Power
Dictators get things done. Journalist Lincoln Steffens visited the Soviet Union in 1919 and said,
“I have seen the future and it works.”
He believed that it “…was a temporary condition of evil, which is made tolerable by hope and a plan.”
Justin Trudeau expressed “a level of admiration” for the Chinese government “…because their basic dictatorship is allowing them to actually turn their economy around on a dime.”
Trudeau also praised Fidel Castro as a “remarkable” and “larger than life leader who served his people” .
Western democracies grew from a different root. The writers of the British North America Act knew that they were not just creating a country. They were preventing autocracy, which can lead to tyranny.
They wanted to immunize Canada against the concentration of power.
Canada was built to prevent power falling to any individual or group. The founders cared more about tyranny than efficiency. They built a complicated political system, not something clean and neat. They did this with intention.
The founders held a firm belief that mankind is frail and imperfect.
After a few thousand years of failed political experiments, the founders knew that men are prone to error. Feminists wonder why it took men so long to figure it out.
The Separation of Powers Doctrine
The best guarantee against tyranny is to build a system that prevents the concentration of power. This is called the separation of powers doctrine.
- The legislative branch writes laws: the House of Commons and Senate.
- The executive branch, also known as The Government, looks after: national defence, foreign affairs, banking, the post office, etc. The Government is made up of the ruling party: The Prime Minister, the Cabinet and the Governor General.
- The judicial branch interprets and applies laws through the court system.
The Supreme Court calls the doctrine one of the “essential features of the constitution.” No one, and no single group, can be trusted to act in a fair and just manner all the time.
Are Medical Regulators Autocratic?
If self-regulation is dead, the the College holds all the power. Many say that the college has held all the power for years; might as well have it in the open.
Fear of tyranny makes doctors do strange things. They order tests to cover themselves.
Doctors spend time writing clinical notes to please regulators, not adding value to patient care.
This takes time away from patients. It makes care more expensive and less efficient. It puts patients at risk with unnecessary tests.
Medical regulation is one of the biggest cost drivers of malpractice insurance.
Lawsuits are brutal. But when doctors prefer lawsuits to college complaints, something is wrong.
Government needs to address the concentration of power currently held by the College. This problem is not new. Will the next government have the courage to fix it?
Photo credit: bokbluster.com